汤氏曰∶小儿乳哺,须要得法,乳者、你也,哺者、食也,乳后不得便与食,
哺后不得便与乳,小儿脾胃怯弱,乳食相并,难以克化,周岁以上,必成乳癖食癖,
于腹中作疼作热,疳病从此起也。丹溪曰∶血气俱盛,食物易消,故食无时,然肠
胃尚脆而窄,若稠粘干硬,酸咸甜辣,一切鱼肉,水果,湿面,烧炙煨炒,俱是发
热难化之物,皆宜禁绝,只与熟菜白粥,非惟无病,且不纵口,可以养德,此外,
生栗味咸,干柿性凉,可为长阴之助,然栗太补,柿太涩,俱为难化,亦宜少与,
妇人无知,惟务姑息,畏其啼哭,无所不与,积成痼疾,虽悔何及,所以富贵骄养,
有子多病,迨至成人,筋骨柔弱,有食则不能忌口以自养,居丧则不能食素以尽礼,
小节不谨,大义亦亏,可不慎欤。至于乳母,尤宜谨节,饮食下咽,乳汁便通,情
欲中动,乳脉便应,病气到乳,汁必凝滞,儿得此乳,疾病立至,不吐则泻,不疮
则热,或为口糜,或为惊搐,或为夜啼,或为腹痛,病之初来,其溺必少,便须询
问,随证治母,母安亦安,可消息于未形也。
凡乳母血气,为乳汁也,五情善恶,悉血气所生,宜戒喜怒,一切禁忌,不用
狐臭、瘿 、气嗽病者,及身体疥癣,头疮发少,紧唇耳聋,音哑 鼻,痫病等,
方可乳儿。夏中盛热时,乳母浴后,或儿啼,不可与你,能使儿成胃毒,秋成赤白
痢,浴后可令定息,良久,热燥乳之,故无患也。聂氏曰∶盛啼,不可食乳,恐气
逆不顺,聚而为 ,亦能成惊风也。《千金》论曰∶凡乳儿不可过饱,饱则溢
而成呕吐,若乳来多猛,取出、 后再乳,切须乳时,合先令捏去宿热乳,然后乳
之,如乳母欲卧寐,当以臂枕之,令乳与儿头平,母欲睡着时,即夺其乳,恐其不
知饱足,亦成呕吐,父母交合之间,儿卧于侧,或惊起,不可乳儿,盖气乱未定,
必能杀儿也。巢氏云∶小儿啼未定,气息不调,母不可以乳饮,盖恐乳不得下,停
滞胸膈,则为呕吐也。《颅囟经》曰∶夏不去热乳,令儿呕吐,冬不去寒乳,令儿
泄泻复痢,尤不可不谨。夜间乳儿,母起身坐,抱儿喂之。每清早欲饮乳,
皆须捏去宿乳。乳汁勿投于地,虫蚁食之,令乳无汁,可沃东壁上佳。
汤氏说:给小儿哺乳喂养,必须讲究方法。所谓“乳”,就是喂奶;所谓“哺”,就是喂辅食。喂奶之后不能立刻喂食,喂食之后不能立刻喂奶。因为小儿的脾胃功能怯弱,如果奶和食物同时进入体内,难以消化。到了周岁以后,必然形成“乳癖”或“食癖”(因乳食停滞形成的积块),在腹中引起疼痛和发热,“疳病”(小儿慢性消耗性疾病)也就从此产生了。
丹溪先生说:人的血气旺盛时,食物容易消化,所以可以随意进食。然而婴儿的肠胃依然脆弱且狭窄,像稠粘、干硬、酸咸甜辣的食物,一切鱼肉、水果、湿面、烧烤煨炒之物,都是容易导致发热且难以消化的东西,都应该禁止食用。只应给予熟菜和白粥,这不仅能预防疾病,还能防止孩子养成贪吃的坏习惯,有助于培养品德。此外,生栗子味道咸,干柿子性质凉,可以作为滋养阴液的辅助,但是栗子过于滋补,柿子过于涩滞,都难以消化,也应该少量给予。
妇女无知,只知道一味地姑息溺爱,害怕孩子啼哭,什么都给孩子吃,最终积成顽固的疾病,即使后悔也来不及了。所以富贵人家骄纵养育的孩子,往往多病,等到成年后,筋骨柔弱,有食物时不能忌口以自我调养,守丧时不能吃素食以尽礼节,小节不谨慎,大义也会亏损,能不慎重吗?
至于乳母,尤其应该严格节制饮食。饮食咽下后,乳汁就会通畅;情欲一动,乳脉就会响应。如果病气传到乳房,乳汁必然凝滞,孩子吃到这种乳汁,疾病会立即发生,不是呕吐就是腹泻,不是生疮就是发热,或者成为口糜(口腔黏膜溃疡),或者惊厥抽搐,或者夜间啼哭,或者腹痛。疾病刚发生时,孩子的尿量一定很少,必须询问清楚,根据症状治疗母亲,母亲安好,孩子才能安好,要在疾病未形成之前加以斟酌处理。
凡是乳母的血液和气,化生为乳汁。人的五种情绪(喜、怒、忧、思、恐)的好坏,都由血气所产生。因此,乳母应该戒除喜怒,一切禁忌包括:患有狐臭、瘿瘤(甲状腺肿大)、气嗽病的人,以及身体患有疥癣、头部有疮疡、头发稀少、嘴唇紧束、耳聋、声音嘶哑、鼻塞、癫痫等疾病的人,都不可以哺乳婴儿。夏季盛热之时,乳母洗澡后,或者婴儿啼哭时,不可以立即喂奶,这会使婴儿患上胃毒,秋季变成赤白痢疾。洗澡后可以让乳母休息片刻,待气息平稳、燥热消退后再喂奶,这样就没有祸患了。
聂氏说:婴儿剧烈啼哭时,不可以喂奶,恐怕气机逆乱不顺,积聚而成痰饮,也能引发惊风。《千金方》论述说:凡是喂养婴儿不可过饱,过饱则溢出导致呕吐。如果乳汁来得又多又猛,应先挤出一些,然后再喂。喂奶前,务必先让母亲捏挤掉残留的热奶,然后再喂。如果乳母想要睡觉,应当用手臂垫着,使乳头与婴儿头部平齐。当母亲快要睡着时,应立即拿走乳头,恐怕婴儿不知道饱足,也会导致呕吐。父母行房事之间,婴儿睡在旁边,或者受惊起身,不可以喂奶,因为此时气机混乱未定,必定会伤害婴儿性命。巢元方说:小儿啼哭未定,气息不调顺,母亲不可以喂奶,恐怕乳汁无法下行,停滞在胸膈,从而导致呕吐。《颅囟经》说:夏天不除去热奶,会导致婴儿呕吐;冬天不除去寒奶,会导致婴儿泄泻并再次患痢疾,尤其不可不谨慎。夜间喂奶,母亲起身坐好,抱着婴儿喂。每天清晨想要喂奶时,都必须捏挤掉隔夜的残奶。乳汁不要倒在地上,如果被虫蚁吃了,会导致乳汁减少,可以浇灌在东墙上是好的。
Mr. Tang said: Infant feeding and nursing must be done with proper methods. "Nursing" refers to breastfeeding, while "feeding" refers to giving solid food. One should not give food immediately after breastfeeding, nor breastfeed immediately after feeding. This is because infants have weak spleen and stomach functions; if milk and food enter the body simultaneously, they are difficult to digest. By the age of one year, this will inevitably lead to "Ru Pi" (milk accumulation) or "Shi Pi" (food accumulation), causing pain and heat in the abdomen, from which "Gan disease" (infantile malnutrition syndrome) originates.
Mr. Danxi stated: When blood and qi are abundant, food is easily digested, so eating can be irregular. However, an infant's intestines and stomach remain fragile and narrow. Foods that are thick, sticky, dry, hard, sour, salty, sweet, or spicy, as well as all meat, fish, fruits, wet noodles, roasted, baked, simmered, or fried items, are substances that induce heat and are difficult to digest; these should be strictly prohibited. Only cooked vegetables and white rice porridge should be given. This not only prevents disease but also curbs gluttony, thereby fostering virtue. Additionally, raw chestnuts are salty in flavor, and dried persimmons are cool in nature, serving as aids to nourish yin. However, chestnuts are too tonifying, and persimmons are too astringent; both are difficult to digest and should be given sparingly.
Ignorant women often indulge their children out of fear of crying, giving them anything they want, eventually accumulating chronic illnesses, for which regret would be futile. Therefore, children raised in wealthy families with indulgence tend to be frequently ill. Upon reaching adulthood, their bones and sinews remain weak; they cannot observe dietary restrictions to maintain health when food is available, nor can they eat vegetarian food during mourning to fulfill ritual propriety. Neglecting minor details leads to a deficit in major principles. Can one not be cautious?
Regarding the wet nurse, strict dietary control is especially necessary. What the mother eats enters her milk supply; emotional states affect the quality of blood and qi. Thus, she should avoid excessive joy and anger. Contraindications include those suffering from bromhidrosis (fox odor), goiter (thyroid enlargement), or cough due to qi stagnation, as well as those with skin diseases like scabies and tinea, head sores, sparse hair, tight lips, deafness, hoarseness, nasal obstruction, or epilepsy. Such individuals should not breastfeed. During the intense heat of summer, after a bath, or if the infant is crying, breastfeeding should be avoided, as it may cause "stomach toxin" in the infant, leading to bloody and purulent dysentery in autumn. After bathing, the mother should rest until her breath stabilizes and internal heat dissipates before breastfeeding, thus avoiding harm.
Mr. Nie stated: Breastfeeding should not occur while the infant is crying violently, as this may cause qi rebellion and accumulation, potentially triggering convulsions. The *Qianjin Fang* discusses that infants should not be overfed; overfeeding leads to regurgitation and vomiting. If the milk flow is too forceful, some should be expressed first before feeding. Before nursing, the mother must squeeze out any residual "hot milk" (stagnant milk). If the mother wishes to sleep, she should support herself with her arm to keep the nipple level with the infant's head. When the mother feels sleepy, she should remove the nipple to prevent the infant from overeating and vomiting. During conjugal relations, if the infant is nearby or startled awake, breastfeeding must be avoided, as the chaotic state of qi at that time can be fatal to the infant. Chao Yuanfang stated: If an infant has not stopped crying and their breathing is irregular, the mother should not breastfeed, lest the milk fail to descend and stagnate in the chest and diaphragm, causing vomiting. The *Luxin Jing* states: In summer, failing to discard hot milk causes infant vomiting; in winter, failing to discard cold milk causes infant diarrhea and subsequent dysentery. Caution is paramount. At night, the mother should sit up and hold the infant while feeding. Every morning before the first feed, residual overnight milk must be squeezed out. Do not pour milk on the ground; if insects or ants consume it, it is believed to reduce milk production. It is better to pour it on the eastern wall.